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Sugar: Should You Worry About It?

By Dr. Marisa Weiss on April 10th, 2013 Categories: Uncategorized

We live in a sweet-crazed world. Sweet, sugary foods taste delicious, make us feel good, and border on addictive. Our latest love affair with cupcakes is just the tip of the iceberg — or icing, in this case! Many of us consume sugar at just about every meal and snack time, maybe without even realizing it.

We no longer need a celebration to bring out the treats. Since the 1970s, our calories from sugar have increased by 50%. According to the American Heart Association, people in the U.S. eat an average of 22 teaspoons of added sugar a day (355 calories).

That’s a LOT of added sugar! Especially when we know we should be careful about how much of it we eat. Experts have long blamed the empty calories in added sugar for contributing to America’s ever-growing overweight problem.

But is there more to the story than just excess calories? Should we also reduce our sugar intake to prevent disease? Are all the sugars the same? And can avoiding sugar help prevent cancer? These are just some of the questions that concern many of my patients. We have some important answers in this column.

Should we avoid sugar to prevent disease? Are all the sugars the same?

For those of us who don’t have certain diseases such as diabetes, it remains unclear whether, how, and in what quantities sugar can harm us. Scientists do know, though, that too much sugar — specifically, refined “table” sugar and high fructose corn syrup (HFCS) — can sabotage the body’s normal functioning.

The body appears equipped to handle foods containing moderate amounts of sugar, such as fruit. But when you drink a can of soda, for instance, the body is flooded with up to 10 teaspoons of highly processed liquid sugar. And soda contains no protein, fiber, vitamins, minerals, or antioxidants to buffer the negative effects.

The calories in sugar that aren’t needed for energy may be turned into fat, which is why sugar may cause weight gain.

Excess sugar also stresses the body in other ways, based on how it is metabolized in the cells. We can break down one of the two main molecules in sugar — glucose — in all of the cells in our body. Glucose is important because the cells use it to generate energy, and it’s the main source of energy for the brain and your body. For example, runners load up on starches containing glucose, which their bodies store as glycogen for a quick source of energy during a marathon. Glucose is the sugar in your “blood sugar.”

The other sugar type, fructose, is a different story. The liver bears the burden of breaking down the other main molecule in sugar — fructose — using a different pathway. The fructose in fruit is embedded in fiber and is released into your body slowly over time. But the sweeteners often used in sodas, candies, and other treats are loaded with fructose. The liver converts extra fructose into fat, not glycogen. Over a long period of time, a condition called insulin resistance can develop. Insulin is a hormone naturally produced in the body and is the “king” of fat. It’s in charge of storing extra blood sugar, and it’s also in charge of converting fat into energy. When the body develops a resistance to insulin, your body has trouble dealing with blood sugar and breaking down fat. Glucose builds up in the blood and body fat increases.

Insulin resistance is a serious condition because it causes inflammation, high blood sugar (hyperglycemia), and obesity. Plus, it greatly increases the risk for diabetes, heart disease, and stroke. It’s possible that insulin resistance — and specifically, too much fructose — also stimulates the growth of some cancers.

And as if that’s not enough, high fructose intake doesn’t turn off your appetite like glucose-containing foods do. So people who load up on high fructose foods and beverages don’t feel full and keep on eating and drinking. When eating or drinking large amounts of anything sweet, a rapid increase in blood sugar occurs, triggering an insulin reaction, followed by a drop in blood sugar, and then often a craving for more sweets.

Can avoiding sugar help prevent cancer?

Again, we need more research in order to know for sure. A panel of international cancer experts found the evidence on the role of sugar in cancer to be limited and inconclusive. There was enough data, though, to cause the panel to advise steering clear of sugary drinks and other foods with a high sugar content because they promote weight gain.

And the panel did find convincing evidence that our overall diet plays a role in some cancers, particularly if dietary choices lead to excess weight gain. Being overweight can increase the risk for different types of cancer, including breast cancer. Fat cells make estrogen; extra fat cells mean more estrogen in the body — and that extra estrogen over time may overstimulate breast cells, possibly leading to the development and growth of hormone-receptor-positive breast cancers. Many of the chemicals in the environment that act like estrogen dissolve in fat — so if you carry excess fat, your body may hold onto more of these chemicals, too.

Finally, when you bring in a lot of calories into your body at one time — and remember, sugary foods tend to be high in calories — it can put your digestive system under more stress. Stress can trigger unhealthy reactions in your body. Growth factors in your bloodstream can increase. Higher level of these growth factors over time might overstimulate your cells and potentially trigger the growth of some types of cancer cells.

How to reduce the amount of sugar you eat

If you’re trying to lose weight or just eat healthfully, often the first advice you hear is to cut added sugar out of your diet. This is good advice. Added sugars don’t provide any essential nutrients. Added sugar also causes your blood sugar to spike. While this provides a quick boost of energy, it doesn’t last. Blood sugar quickly drops again, leaving you sluggish and craving more sweets — which can make it hard to stick to a sensible diet.

So what’s the best way avoid sugar when research suggests our bodies are hard-wired to crave sweetness? Over the years, our nutrition advisors at Breastcancer.org have weighed in on this topic. Here’s their advice:

  • Don’t try to cut it out completely. It’s very difficult to cut one thing, such as sugar, completely out of your diet for any lengthy period of time.
  • Limit added sugar in food preparation and at the table. If you’re baking, try using less sugar than the recipe calls for. Often you won’t notice the difference.
  • Really do use portion control. If you eat a moderately sized dessert, your body’s digestive system is able to handle the sugar and the calories. But you’ll  overload your system with, say, half a gallon of ice cream in half an hour.
  • When you do have dessert or a sweet snack, truly savor every bite. Avoid mindlessly eating processed food high in sugar.
  • Don’t worry about the natural sugars that occur in fruits and vegetables. This sugar is not processed and comes packaged with fiber to slow digestion. Fruits and vegetables also contain vitamins, minerals, and antioxidants – unlike cookies and candy.
  • Beware that sugar is a common food additive and often hidden on food packaging under other names like corn sweetener, honey, maple syrup, and molasses. Any ingredient that ends in syrup or -ose, such as sucrose or maltose, is likely to be sugar.
  • Don’t stock high-sugar snacks and candy in the pantry.
  • Drink water and unsweetened teas. Avoid lemonade, sweetened teas, and sodas. Even “diet” sodas can fool your body and interfere with weight loss.

Allowing yourself a sweet treat every now and then shouldn’t be a reason to worry. Just be sure that the bulk of the food that you eat everyday is healthy.

One thing that works very well for me is to take full advantage of natural sugars. By roasting apples, their natural sugar comes out, caramelizes, and turns into a fabulous dessert or treat. Instead of ice cream, you can eat caramelized apples with plain Greek nonfat yogurt. Pears, peaches, plums, and many other fruits roast beautifully.

The best caramelization happens when you roast in a cast iron pan: just put plain cut-up apples in a cast iron pan. Roast for 25 minutes in a preheated oven at 425 degrees, then drop down to 350 and roast for another 25 minutes. I do the same thing with vegetables like sweet potatoes, Brussels sprouts, beets, and carrots. You can spruce them up with a little olive oil, sea salt, fresh rosemary, garlic and/or ginger. You’d be amazed how much natural sweetness and flavors come out from Mother Nature with NO added sugar!

How do you feel about avoiding or limiting sugar in your diet? Have you found successful ways to cut back on how much you eat? As someone who is always in search of the next chocolate fix, I’d appreciate hearing your advice! For starters, I stick to > 70% dark chocolate.

Dr. Marisa Weiss

Marisa Weiss, M.D. is the founder, president and guiding force behind Breastcancer.org, the world's most trafficked online resource for medically reviewed breast health and breast cancer information, reaching over 8 million visitors per year. A breast cancer oncologist with over twenty years of active practice in the Philadelphia region, Dr. Weiss is regarded as a visionary advocate for her innovative and steadfast approach to informing, empowering, and treating patients with breast cancer.

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